This project will investigate certain aspects of the etiology, pathogenesis, and management of chronic suppurative otitis media without cholesteatoma (CSOM). In the pediatric population CSOM is a prevalent, troublesome disease process in which pathogenesis, effective treatment and prevention are not well established. Specifically, we plan to investigate whether, 1) Pseudominas aeruginosa is etiologic of CSOM; 2) CSOM can lead to sensorineural hearing loss; 3) topical mediations are ototoxic in the presence of CSOM (inflamed middle ear); 4) incompletely treated or untreated acute otitis media leads to CSOM. The research will be divided into 2 phases. Phase I will involve the final development of a chinchilla animal model of CSOM. The virulence of different strains of P. aeruginosa will be examined. The stages of CSOM will be evaluated by histopathologic methods. The effect of CSOM on sensorineural hearing will be studied. Phase II will address: 1) the ototoxicity of topical agents in the presence of CSOM, histopathologically and audiometrically; 2) whether incompletely treated or untreated acute otitis media leads to CSOM.